title: Preservation techniques for donors after cardiac death kidneys.
abstract: OBJECTIVE
  The purpose of the present review is to describe the techniques currently used to preserve kidneys from donors after cardiac death.
  
  
  RESULTS
  Automated chest compression devices may be used to improve organ perfusion between cardiac death and preservation measures. Normothermic extracorporeal membrane oxygenation reduces warm ischemic injury and has the ability to improve organ viability in donors after cardiac death.
  
  
  CONCLUSIONS
  Kidneys from donors after cardiac death expand the donor pool but are inevitably subjected to a period of warm ischemia. Reduction of warm ischemic injury to the organs improves transplant outcome. To reduce this injury in organs from donors after cardiac death, different preservation techniques are used. Automated chest compression devices improve organ perfusion between cardiac death and the start of organ preservation. In-situ preservation with double-balloon triple-lumen catheter is an easy technique to preserve organs in uncontrolled donors and is used in many centers to cool and flush the organs. In controlled donors, organs can also be flushed after laparotomy and direct cannulation of the aorta. Extracorporeal membrane oxygenation reduces warm ischemic injury and the use of normothermic perfusion seems promising. Optimal preservation is essential to improve the viability of kidneys from donors after cardiac death, to fully utilize this large donor pool.
authors.affiliation: Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands. t.wind@mumc.nl
authors.forename: Jentina
authors.initials: J
authors.lastname: Wind
authors.forename: E R Pieter
authors.initials: ER
authors.lastname: Hoogland
authors.forename: L W Ernest
authors.initials: LW
authors.lastname: van Heurn
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects / Q000295:instrumentation; D004867:Equipment Design; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects; D006801:Humans; D016030:Kidney Transplantation; D009392:Nephrectomy; D009926:Organ Preservation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D015427:Reperfusion Injury / Q000209:etiology / Q000517:prevention & control; D014019:Tissue Donors / Q000600:supply & distribution*; D052096:Warm Ischemia / Q000009:adverse effects